MedWire News: A large prostate weight does not increase the risk of incontinence or biochemical failure after radical prostatectomy and may protect against impotence, suggests research from the Cleveland Clinic Foundation in Ohio, USA.

To determine the impact of prostate weight on patient outcomes, Monish Aron and co-workers examined 327 men who underwent laparoscopic radical prostatectomy between 2003 and 2006.

The majority (68%) of the men had a pathologic prostate weight of 30-75 g , while 9% had a prostate weighing ≤30 g, and 23% a prostate weighing ≥75 g.

The patient groups were comparable in terms of age, body mass index, pre-operative prostate-specific antigen level, and clinical stage.

Analysis showed that prostate weight did not predict length of operation or hospital stay, catheterization time, or the likelihood of biochemical recurrence or urinary incontinence 1 year after surgery.

However, men with a prostate weighing 30 g or less were more likely to have a positive surgical margin than men with a medium or large prostate (39% vs 16% and 27%, respectively). Large prostates were also associated with poorer rates of potency 1 year after surgery regardless of whether the men had undergone nerve sparing surgery (47% vs 75% and 79%, respectively).

There was also a positive correlation between blood loss and prostate size, with patients with small, medium, and large prostates losing an estimated 204 ml, 256 ml, and 340 ml, respectively.

"Prostate size has no effect on continence or biochemical recurrence at 1 year after laparoscopic radical prostatectomy, but affects intra-operative blood loss, potency and surgical margins," Aron et al write in the BJU International.

But they caution: "More patients with a longer follow-up are needed to confirm these findings."

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